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A report out today on the high cost of obesity serves to highlight, once again, that there is so much more to the Affordable Care Act than what has met the public’s eye.

Reuters is reporting that obesity in America is now adding an astounding $190 billion to the annual national healthcare price tag, exceeding smoking as public health enemy number one when it comes to cost.

“Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of HealthEconomics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.”

The high cost of being significantly overweight manifests in a variety of ways, ranging from the increased insurance premiums we all pay to subsidize the added medical charges incurred by the obese to the surprisingly dramatic impact our collective pounds has on energy costs.

According to Sheldon Jacobson of the University of Illinois, the extra weight carried by vehicles as a result of obese and overweight Americans is responsible for almost one billion additional gallons of gasoline being burned each year by our automobiles—nearly 1 percent of our total gasoline usage.

What you may not know is that the Affordable Care Act directly confronts this crisis in a number of ways— beginning with empowering employers to battle obesity by allowing them to charge obese employees 30 to 50 percent more in what they contribute toward their health insurance benefit should an employee refuse to participate in a qualified wellness program designed to help them lose weight. You may also not know that the reform law includes incentives to Medicare and Medicaid beneficiaries to get them into a primary care doctor to discuss and execute a weight loss program. Obamacare even funds community programs designed to help people take off the extra pounds.

How serious is the problem? Obesity has risen a full 34% since 1960 while morbid obesity is up sixfold.

Making the cost impact all the more troubling is the fact that, unlike smokers, obese people tend to live almost as long as those who keep their weight under control. "Smokers die early enough that they save Social Security, private pensions, and Medicare" trillions of dollars", said Duke's Eric Finkelstein. "But mortality isn't that much higher among the obese."

While the preventative medicine approach to cost controls which lay at the very heart of the Affordable Care Act directly tackles the serious impact of obesity on our healthcare costs, nothing in the GOP proposals now emerging as potential replacement legislation, should the ACA be stricken by the Supreme Court, appear to address the problem in any meaningful way.